You hear a lot about bad LDL cholesterol and good HDL cholesterol. But it turns out that when it comes to heart health, that’s not the whole story.

Lipoprotein(a) is a particle in your blood that is made up of fats and proteins. Everyone has some, but for around 20% of people there’s too much, and it can attach LDL cholesterol to your aortic heart valve and artery walls, causing inflammation of heart tissue and cardiovascular disease.

Most of the time, elevated Lp(a) levels result from a genetic predisposition, which can be spotted with a simple blood test.

It’s smart to have a test if you have a family history of early cardiovascular disease or aortic valve disease; if you have LDL cholesterol over 70 mg/dL, even though you take medicine to lower it; and/or you have heart or blood vessel disease even though your doctor says your cholesterol and triglyceride levels are normal.

When people develop elevated Lp(a) without any genetic trigger, it may be caused by hyperthyroid or hypothyroid conditions, as well as chronic kidney or liver disease.

How do you lower Lp(a)?

You can’t do it directly, but you can protect your heart by eating fiber-filled produce, exercising, sleeping for seven to eight hours nightly, managing stress, maintaining a healthy weight, and not smoking — and, most importantly, by getting your LDL below 50 mg/dL.

Currently, there are three Lp(a)-lowering medications in phase 3 trials; we’ll let you know when any are approved.